Predicting lethal outcome after severe head injury ? A computer-assisted analysis of neurological symptoms and laboratory values

Abstract

A total number of 58 parameters (laboratory values, neurological symptoms, and vegetative parameters) were evaluated in 150 patients during the first seven days after severe head injury. The patients were divided into two groups, "survivors" and "non-survivors". Eight easily evaluable routine parameters with the most significant differences between the two groups of patients were used for statistical evaluation of a "no survival chance score". These highly indicative parameters are serum osmolarity and urea, blood glucose, total bilirubin, motor reaction to stimuli, body temperature, respiratory activity, and pupil reaction. A "low survival chance limit" was evaluated from each of these parameters by computer analysis. None of the patients in the series survived when three or more of these eight parameters had climbed beyond the limit. So far, the system is able to predict "no survival chances" in 50.8% of the non-survivors some six days prior to death; 80% of these predictions could be made by the fourth day after injury.

Fever is associated with third ventricular shift after intracerebral hemorrhage: Pathophysiologic implications

“…Fever is associated with a worse outcome after brain injury. [26][27][28] A recent meta-analysis showed that in patients with ischemic stroke, fever is associated with a marked increase in morbidity and mortality. [29][30][31][32][33][34] Few studies have examined the relationship of fever and outcome in patients with intracerebral Deogaonkar et al: Fever after intracerebral hemorrhage hemorrhage.…”

Research at the Department of Medical Informatics, Statistics and Documentation of the University of Graz

“…We try to check all our own developments for negative side-effects and there are successful programs that were never put into clinical operation because we could not exclude the possibility of harmful results (e.g. predicting lethal outcome after severe head injury [25]). To counter negative side-effects we also engage in policy setting, normative work and education for data protection, telemedicine etc.…”